PARTNERSHIP for
PUBLIC HEALTH LAW
Advancing Public Health Through Law
Regulation of Synthetic Drugs
Synthetic Drugs and Impact on Public Health
PARTNERSHIP for
PUBLIC HEALTH LAW
Popular synthetic
Synthetic drugs are chemically produced and mimic or enhance the effects
cannabinoid product
of illicit drugs. These drugs fall into two categories:
names include K2, Spice,
Advancing Public Health Through Law
Blaze and Black Mamba.
NN Synthetic cannabinoids, also known as synthetic marijuana, are designed to
Popular synthetic
elicit the same “high” that users get from the THC (tetrahydrocannabinol)
cathinone product names
contained in marijuana. The synthetic cannabinoid is sprayed onto plant
include Ivory Wave,
material, which is dried for smoking or oral ingestion. These products are
Bloom, Vanilla Sky and
typically sold in retail stores as herbal incense, potpourri or herbal smoking
White Lightning.
blends.
NN
Synthetic cathinones function as synthetic stimulants, designed to affect the
central nervous system similar to the impact of drugs such as cocaine and
amphetamines. These drugs are laboratory produced. They are sold in powder form for snorting and may be injected intravenously or taken by mouth.
These products are typically sold in retail stores as bath salts or jewelry
cleaner.
Companies selling synthetic drugs as legal products, like incense or bath
salts, attempt to avoid liability for harm from use of the products as drugs by
labeling the products as not intended for human consumption. These labels
have no impact on the applicability of local, state or federal laws that limit
or prohibit the sale of synthetic drugs. Just like cocaine may not be sold as a
kitchen cleaner, banned synthetic drugs may not be sold as incense. These
labels do, however, hinder enforcement efforts as law enforcement and
health officials may not be able to identify the products being used as drugs
and creating public health problems.
Because they are relatively new and vary in chemical composition, there
is limited research on the short-term and long-term health effects of these
drugs and even less research on the impact on public health. The research
and data available, however, give good reason for concern. Synthetic cannabinoids were originally produced to assist in research on the impact of
cannabinoids on brain function and pain management. The effects of the
synthetic drugs, however, may be ten times higher than of THC. For example, from 2010 to 2012, Poison Control Centers across the country received
approximately 9,000 calls related to bath salt use and bath salts were responsible for over 20,000 drug-related emergency department visits in 2011.
In 2010, synthetic cannabinoids led to over 11,000 emergency department
visits, 75% of which involved patients between the ages of 12-29. Synthetic
cannabinoids are popular among high school students. Evidence suggests
that youth are the primary consumers of synthetic cathinones.
Reported harmful effects
of synthetic cannabinoids
include nausea, increased
agitation, elevated blood
pressure and acute kidney
injury.
Synthetic cathinones
may cause chest pain,
increased heart rate,
hallucinations, paranoia
and delusions; and
they may create deep
cravings like their natural
counterparts.
Detailed charts on relevant
state legislation are
available from the National
Conference of State
Legislatures. http://www.
ncsl.org/issues-research/
justice/synthetic-drugthreats.aspx
Federal Laws Applicable to Synthetic Drugs
Federal law—the Controlled Dangerous Substances Act—
regulates the sale of a variety of drugs, including imposing
prescription requirements for certain substances and banning
the sale and use of others. The level of regulation is determined by the schedule on which the drug is listed. At the
high end of the scale,
For example, Ocean
Schedule I drugs presCity, Maryland, a popular
ent significant risk of
tourist destination that
addiction and serve no
attracts teens and
medical purpose; these
young adults, bans
drugs may not be sold
“cannabimimetic agents”
or used. At the low end,
as well as “noncontrolled
Schedule V drugs present
substance[s] that the
little risk of abuse and
person reasonably
may be used effectively as
believes is a
medicine. Recognizing
hallucinogenic chemical
that chemical substances
substance.” Ocean City,
similar to controlled
Maryland, Code, Title IV,
substances present health
§§58-181 to 58-183.
risks, Congress passed the
Controlled Substances
Analogue Enforcement Act of 1986, Subtitle E of the AntiDrug Abuse Act of 1986 (P.L. 99-570). The Act includes in
Schedule I drugs that are substantially similar to listed drugs;
however, the definition of analogue drug is somewhat restrictive. In 2012, Congress passed the Synthetic Drug Abuse
Prevention Act, Subtitle D of Title XI of the Food and Drug
Administration Safety and Innovation Act (P.L. 112-144), directly adding several synthetic substances to Schedule I. The
Drug Enforcement Agency has added more synthetic substances to Schedule I; these are temporary listings that must
be approved by Congress within three years. As a result of
these laws, those who produce, sell, use or possess many synthetic drugs may be subject to federal criminal prosecution.
State and Local Laws Applicable to Synthetic Drugs
States have also responded with legislation: 43 states have
passed laws prohibiting certain synthetic cannabinoids and 44
states have passed laws prohibiting certain synthetic cathinones. Some state laws identify particular chemical compounds that are unlawful. For example, Arizona law contains
an extensive list of prohibited chemical compounds. Arizona
Revised Statutes, §13-1401. Other state laws use generic language so as to include any number of synthetic drugs. For example, Colorado law lists specific prohibited compounds but
also prohibits cathinones generally, defined as “any synthetic
or natural material containing any quantity of a cathinone
chemical structure, including any analogs, salts, isomers, or
salts of isomers of any synthetic or natural material containing a cathinone chemical structure.” Colorado Revised Statutes,
§18-18-102. There is a trend toward these more generic definitions. As with federal law, these provisions typically add the
new substances to existing prohibitions on production, sale,
use or possession and require criminal prosecution for enforcement. The advantage of the generic definition is that the
law is able to keep pace with the creativity of those manufacturing the products. With narrow definitions of prohibited
drugs, manufacturers need only make a modest change to the
chemical composition of the product to avoid regulation.
Local legislatures have also taken action, typically with respect to a particular product of concern. Some jurisdictions
have taken action broadly or with respect to a particular retailer under the local jurisdiction’s nuisance abatement power.
Because many states preempt local legislation of controlled
dangerous substances to some extent, interested local policymakers should consult with counsel before pursuing legislation to better understand in what ways the local legislature
may regulate synthetic drugs.
Public Health Response to Synthetic Drug Use
Federal and state laws prohibiting the production, sale, use
or possession of synthetic drugs are an important element in
the public health response to this burgeoning problem. But
law enforcement officials face significant hurdles in pursuing criminal charges against those who sell synthetic drugs.
Even with the generic or catch-all language, expert testimony
about the chemical composition of the product and its effect
on the human body are likely required. Additionally, labeled
as legal products like incense or bath salts, enforcement officials struggle to identify and punish retailers. These difficulties coupled with the dynamic nature of these drugs require
a public health response. Because synthetic cannabinoids and
cathinones are relatively new products, informing the public
about the risks of use is imperative. This includes incorporating information about synthetic drugs into youth drug education programs as well as broader public education so that
retailers, parents and other adults are aware of these products.
This is particularly true as many of the popular products
are marketed in a deceptive manner, with labeling as herbal
incense or bath salts not intended for human consumption.
Assuring that the medical community and health departments
are aware of the availability of these drugs and know how to
treat a user is particularly important in communities in which
the drugs are just starting to emerge. Supporting research
into the effects of the drugs will contribute to the ability of
the public health community to respond to this emerging and
dangerous problem.
Sources
Synthetic Drugs: Overview and Issues for Congress, Congressional
Research Service (2013), available at www.fas.org/sgp/crs/
misc/R42066.pdf.
Synthetic Drugs (a.k.a. K2, Spice, Bath Salts, etc.), Office of
National Drug Control Policy, available at www.whitehouse.
gov/ondcp/ondcp-fact-sheets/synthetic-drugs-k2-spicebath-salts.
“Bath Salts” Were Involved in Over 20,000 Drug-Related
Emergency Department Visits in 2011, The DAWN Report,
Substance Abuse and Mental Health Services Administration,
September 17, 2013, available at www.samhsa.gov/data/spotlight/spot117-bath-salts-2013.pdf
Drug-Related Emergency Department Visits Involving Synthetic
Cannabinoids, The DAWN Report, Substance Abuse and
Mental Health Services Administration, December 4, 2012,
available at www.samhsa.gov/data/2k12/DAWN105/SR105synthetic-marijuana.htm.
Drug Facts: Spice (Synthetic Marijuana), National Institutes of
Health, National Institute on Drug Abuse (2012), available at
www.drugabuse.gov/publications/drugfacts/spice-syntheticmarijuana.
Acute Kidney Injury Associated with Synthetic Cannabinoid Use—
Multiple States, 2012, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, February 15,
2013, available at www.cdc.gov/mmwr/preview/mmwrhtml/
mm6206a1.htm.
Synthetic Drug Threats, National Conference of State Legislatures (2012), available at www.ncsl.org/issues-research/justice/synthetic-drug-threats.aspx.
Bath Salts—Emerging and Dangerous Products, Messages from
the Director, National Institute on Drug Abuse (2011),
available at www.drugabuse.gov/about-nida/directors-page/
messages-director/2011/02/bath-salts-emerging-dangerousproducts.
The Network for Public Health Law is a national initiative of the Robert
Wood Johnson Foundation with direction and technical assistance by the
Public Health Law Center at William Mitchell College of Law.
This document was developed by Kathleen Hoke, JD, Director of the Network for Public Health Law - Eastern Region and Mathew R. Swinburne,
Staff Attorney, Network for Public Health Law - Eastern Region, University of Maryland Francis King Carey School of Law. The Network for Public
Health Law provides information and technical assistance on issues related to
public health. The legal information and assistance provided in this document
does not constitute legal advice or legal representation. For legal advice, please
consult specific legal counsel.